Posterior Segment Complications of Endothelial Keratoplasty

Gibbons, Allister; Chang, Victoria; Yannuzzi, Nicolas A.

doi:10.1097/iio.0000000000000331

Cited by 7 publications

(9 citation statements)

References 92 publications

(97 reference statements)

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“…The incidence of SCH related to endothelial keratoplasty has been estimated to be about 0.05% [50, 51]. Minor fluctuations in IOP observed in Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and Descemet Membrane Endothelial Keratoplasty (DMEK) have been shown to reduce the risk of SCH compared to open-sky surgical approaches [6, 52, 53]. Table 1 shows various studies of SCH in different types of keratoplasties.…”

Section: Surgery-related Schmentioning

confidence: 99%

Suprachoroidal Hemorrhage

Mohan,

Sadeghi,

Mohan

et al. 2023

Ophthalmologica

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Suprachoroidal hemorrhage (SCH) refers to the accumulation of blood in the suprachoroidal space, a relatively uncommon but significant complication that can occur spontaneously, during ophthalmic surgery or as a consequence of ocular trauma. If left undiagnosed and untreated, SCH can lead to severe vision loss or even blindness. Therefore, it is crucial for ophthalmologists to have a thorough understanding of this complication, taking proactive measures to prevent it during surgery and being knowledgeable about effective management strategies for patients with SCH. This review article aims to provide a comprehensive overview of SCH, covering its risk factors, diagnostic approaches, and the best practices for its management. By enhancing awareness and knowledge in this area, we can improve patient outcomes and minimize the impact of SCH in ophthalmic practice.

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Section: Surgery-related Schmentioning

confidence: 99%

Suprachoroidal Hemorrhage

Mohan,

Sadeghi,

Mohan

et al. 2023

Ophthalmologica

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“…Postsurgical macular edema (PSME) may complicate several intraocular procedures, notably surgery for glaucoma, corneal transplant and, most commonly, cataract extraction [1][2][3][4][5]. It has been recognized as the most common cause of visual deterioration after uncomplicated cataract surgery, with rates ranging from 0.1 to 3.8%, and it is specifically known as Irvine-Gass syndrome.…”

Section: Introductionmentioning

confidence: 99%

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes

et al. 2021

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Purpose To assess the rate of occurrence and the risk factors of postsurgical macular edema (PSME) in eyes with idiopathic epiretinal membrane (iERM) or full-thickness macular hole (FTMH). Methods Retrospective longitudinal analysis of all subjects scheduled for vitrectomy with or without combined cataract surgery over a 6-month period. Electronic medical charts and imaging data were analyzed preoperatively and at 1, 3 and 6 months after surgery. Results From 101 patients diagnosed with iERM or FTMH, 71 patients were eligible for the study. Forty-nine eyes with iERM (69.0%) and 22 eyes with FTMH (31.0%) underwent vitrectomy either isolated (31.0%) or combined with cataract extraction (69.0%). The overall rate of PSME was 26.7%, without differences between the two groups (P = 0.9479). Combined cataract extraction did not affect the overall occurrence of PSME rate in both groups (P = 0.9255 in FTMH and P = 0.8658 in iERM). If grouped by stage, eyes with stage 4 iERM though disclosed an increased rate of PSME (57.1%) compared to lower (1 to 3) stages (14.3%, P = 0.0021), particularly when combined with cataract surgery (71.4% vs. 15.4% in stages ≤ 3, P = 0.0021). The PSME odds ratio for a stage 4 iERM is 8 (95% CI: 1.933–33.1; P = 0.0041) compared to stages 3 and below. Conclusions PSME remains a clinically relevant and frequent event after surgery for iERM and FTMH. Patients with stage 4 iERM have an 8-fold higher likelihood of developing PSME in a 6-month postsurgical period compared to iERM in 1–3 stages, especially when combined with cataract extraction.

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“…1 Endothelial transplants may lead to posterior segment complications including endophthalmitis, macular edema, retinal detachment, and suprachoroidal hemorrhage. 2 Graft detachment is one of the most common complications of this procedure. 1 However, detachment with graft dislocation into the vitreous cavity is rare, 2,3 and surgical management is required to prevent permanent vision loss because of the resulting inflammation and potential retinal detachments.…”

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confidence: 99%

Descemet Stripping Automated Endothelial Keratoplasty Graft in-the-Bag Posterior Dislocation

Levine

Gibbons

Martínez

et al. 2023

RETINAL Cases &Amp; Brief Reports

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Purpose: The purpose of this report was to describe a case of a dislocated Descemet stripping automated endothelial keratoplasty graft retained in-the-bag removed with pars plana vitrectomy (PPV). Methods: This was a case report. Results: A 69-year-old pseudophakic man who underwent a repeat Descemet stripping automated endothelial keratoplasty due to bullous keratopathy in the setting of multiple previous ocular surgeries presented with a vision of counting fingers. On examination, a Descemet stripping automated endothelial keratoplasty graft was appreciated behind the intraocular lens obscuring the visual axis and presumed to be in the anterior vitreous. The patient underwent a 23-gauge vitrectomy, and after a posterior capsulotomy, the dislocated graft was removed with a 23-gauge vitrector without complications. The best-corrected visual acuity was 20/50 6 months after the PPV. Grafts can dislocate posteriorly between the intraocular lens and the posterior capsule. The dislocated graft can be successfully extricated with a 23-gauge vitrector after a careful posterior capsulotomy, with good visual outcomes. Importance: To the best of our knowledge, this is the first reported case of an in-the-bag Descemet stripping automated endothelial keratoplasty graft posterior dislocation. Furthermore, we showed an innovative surgical technique for the removal of the dislocated graft with a 23-gauge vitrectomy and posterior capsulotomy.

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Posterior Segment Complications of Endothelial Keratoplasty

Cited by 7 publications

References 92 publications

Suprachoroidal Hemorrhage

Suprachoroidal Hemorrhage

Increased risk of postsurgical macular edema in high stage idiopathic epiretinal membranes

Descemet Stripping Automated Endothelial Keratoplasty Graft in-the-Bag Posterior Dislocation

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